Williams v. Nat'l Union Fire Ins., No. 13-55719 (9th Cir. 2015)
Annotate this CasePlaintiff filed suit against National Union under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001 et seq., which permits a beneficiary of an employee benefit plan to bring a civil action to recover benefits owed under the plan. Plaintiff claimed that her husband's death occurred as a result of an accident as defined by the policy. Plaintiff's husband died as a result of Deep Vein Thrombosis (DVT) shortly after he completed roughly 28 hours of air travel in a five-day period. The court concluded that regardless of whether the husband's death may be characterized as an externally caused “accident” when considering that word in isolation, his loss of life was not within the policy’s coverage. His fatal injury did not directly result from an unintended and unanticipated happening “external to the body.” Accordingly, the court affirmed the district court's grant of summary judgment for National Union.
Court Description: Employee Retirement Income Security Act. Affirming the district court’s summary judgment in an ERISA action, the panel held that an insurer properly denied accidental death benefits to the insured’s family because his death as a result of Deep Vein Thrombosis did not result from an “accident” as defined by the insurance policy.
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